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https://www.readbyqxmd.com/read/29679726/late-presenting-dural-tear-incidence-risk-factors-and-associated-complications
#1
Wesley M Durand, J Mason DePasse, Eren O Kuris, JaeWon Yang, Alan H Daniels
BACKGROUND CONTEXT: Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), though estimates of LPDT range from 0.6 - 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29662739/decompression-in-adult-lumbar-deformity-surgery-is-associated-with-increased-perioperative-complications-but-favorable-long-term-outcomes
#2
Isaac O Karikari, Keith H Bridwell, Aladine A Elsamadicy, Lawrence G Lenke, Patrick Sugrue, David Bumpass, Azeem Ahmad, Jeffrey Gum
Study Design: Retrospective cohort study. Objectives: To analyze the impact of performing a formal decompression in patients with adult lumbar scoliosis with symptomatic spinal stenosis on perioperative complications and long-term outcomes. Methods: Adult patients undergoing at least 5 levels of fusion to the sacrum with iliac fixation from 2002 to 2008 who had a minimum 5-year follow-up at one institution were studied. Patients who had 3-column osteotomy were excluded from the study...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29662730/myelopathy-improvement-following-removal-of-cervical-sublaminar-wiring
#3
Hurtis J Tullos, Robert G Briggs, Andrew K Conner, Allison E Williams, John B Maxwell, Michael D Martin
Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of delayed neurological decline associated with myelopathy, lower extremity spasticity, and associated syringomyelia secondary to instrumentation failure and resultant sublaminar wire protrusion into the cervical spinal cord...
February 14, 2018: Curēus
https://www.readbyqxmd.com/read/29619251/spinal-subdural-hematoma-and-ankylosing-spondylitis-case-report-and-review-of-literature
#4
Darian R Esfahani, Harsh P Shah, Mandana Behbahani, Gregory D Arnone, Ankit I Mehta
Introduction: Spinal subdural hematomas are rare, disabling hemorrhages. Ankylosing spondylitis (AS) is a relatively common inflammatory condition of the spine that can progress to a fragile, unstable fusion vulnerable to fracture. While spinal epidural hematomas have been described, subdural hematomas to date have not been reported in AS. In this report, we describe the unique case of a patient on warfarin with AS who developed a spinal subdural hematoma and fracture in the absence of trauma...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29576906/lower-complication-and-reoperation-rates-for-laminectomy-rather-than-mi-tlif-other-fusions-for-degenerative-lumbar-disease-spondylolisthesis-a-review
#5
REVIEW
Nancy E Epstein
Background: Utilizing the spine literature, we compared the complication and reoperation rates for laminectomy alone vs. instrumented fusions including minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) for the surgical management of multilevel degenerative lumbar disease with/without degenerative spondylolisthesis (DS). Methods: Epstein compared complication and reoperation rates over 2 years for 137 patients undergoing laminectomy alone undergoing 2-3 level (58 patients) and 4-6 level (79 patients) Procedures for lumbar stenosis with/without DS...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29569699/the-posterior-epidural-ligament-in-the-thoracic-region-a-cadaveric-and-histological-study
#6
Christopher Rimmer, Philip Adds
The existence of posterior epidural ligaments (PEL) has been established in the lumbar region, but they have hitherto not been shown to exist in the thoracic vertebral column. Their identification is of clinical significance in respect to incidental durotomy and the circulation of cerebro-spinal fluid. Fourteen thoracic spine sections were dissected by cutting through the intervertebral disc and separating the ligamentum flavum from the vertebra above. The dural sheath was gently retracted anteriorly to identify macroscopic connections between the ligamentum flavum and the dura...
March 23, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29541849/ultrasonic-bone-scalpel-utility-in-cervical-corpectomy-a-technical-note
#7
Bharat R Dave, Devanand Degulmadi, Shreekant Dahibhate, Ajay Krishnan, Denish Patel
PURPOSE: Anterior cervical corpectomy and fusion (ACCF) is a technically challenging surgery. Use of conventional instruments like high-speed burr and kerrison rongeurs is associated with high complication rates such as increased blood loss and incidental durotomy. Use of ultrasonic bone scalpel (UBS) in cervical corpectomy helps to minimize such adverse events. METHODS: We performed a retrospective study based on the data of 101 consecutive patients who underwent cervical corpectomies with UBS for different cervical spine pathologies from December 2014 to December 2016...
March 14, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29532259/intradural-disc-herniation-how-i-do-it
#8
Víctor Rodrigo, Marta Claramonte, Mónica Martín, Juan B Calatayud
BACKGROUND: Intradural disc herniation is a rare phenomenon in spine surgery. Diagnosis is difficult despite current neuroradiologic imaging techniques. METHOD: We present a case of a 59-year-old man with lumbar and radicular pain and a recurrent lumbar herniation. A laminectomy was performed after no clear disc herniation in the epidural space was found and an intradural mass was palpable. A durotomy showed an intradural disc fragment that was removed, followed by an arthrodesis...
March 12, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29476935/outcomes-following-minimally-invasive-lateral-transpsoas-interbody-fusion-for-degenerative-low-grade-lumbar-spondylolisthesis-a-systematic-review
#9
REVIEW
Anshit Goyal, Panagiotis Kerezoudis, Mohammed Ali Alvi, Sandy Goncalves, Mohamad Bydon
A variety of surgical approaches have been described to treat low grade lumbar degenerative spondylolisthesis (DS). Minimally invasive spinal fusion techniques were first introduced to minimize morbidities associated with invasive surgical treatments. Minimally invasive lateral transpsoas interbody fusion, also known as lateral lumbar interbody fusion (LLIF), is a relatively new method of lumbar arthrodesis that avoids various approach related complications compared to its posterior and anterior counterparts...
April 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29471453/modified-minimally-invasive-transforaminal-lumbar-interbody-fusion-technique-can-potentially-improve-safety-of-interbody-graft-placement
#10
Khalid H Kurtom, Wendy S Towers
BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MITLIF) is a well-described procedure with excellent reported outcomes. A modification of interbody graft placement can potentially improve the ease and safety of this procedure. OBJECTIVE: To describe a modification of the MITLIF graft placement and retrospectively review our experience including intraoperative and postoperative complications. METHODS: Single surgeon, single institution, retrospective analysis of consecutive patients who underwent a modified MITLIF technique between November 2011 and December 2013...
February 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29462736/use-of-a-pediatric-craniotome-drill-for-cervical-and-thoracic-spine-decompression-safety-and-efficacy
#11
Christopher Elia, Omid R Hariri, Jason Duong, Fanglong Dong, Raed Sweiss, Dan Miulli
BACKGROUND: Laminectomy, using a high-speed drill with an unprotected cutting drill bit, can be rapid and effective, but it has been associated with known complications. Another technique uses a pediatric craniotome drill with the footplate attachment. At present, there are no studies comparing clinical outcomes between these 2 stated decompressive techniques. METHODS: A retrospective review was conducted at a single institution. Two cohorts of patients were considered based on the technical method of laminectomy for decompression...
February 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29393808/imaging-and-surgical-approach-to-a-pediatric-penetrating-intradural-wooden-splinter-case-report
#12
Gabrielle Santangelo, Jonathan Stone, Tyler Schmidt, G Edward Vates, Howard Silberstein, Pierre Girgis
Penetrating spinal injuries by wood are infrequently reported. They are particularly rare in children. Only 6 cases of wooden fragments causing penetrating intradural spinal injury have been reported. The authors report a case of a 3-year-old girl who suffered a penetrating wound on her lower back after sliding on a wood floor. A portion of the extraspinal part of the wooden splinter was removed prior to presentation; however, a high suspicion for retained foreign body was maintained. Findings on CT were equivocal, but the diagnosis was confirmed on MRI...
February 2, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29346684/comparing-cortical-trajectory-transforaminal-lumbar-interbody-fusions-against-pedicle-trajectory-transforaminal-lumbar-interbody-fusions-and-posterolateral-fusions-a-retrospective-cohort-study-of-90-day-outcomes
#13
James G Malcolm, Michael K Moore, Falgun H Choksh, Faiz U Ahmad, Daniel Refai
BACKGROUND: The cortical screw (CS) trajectory for pedicle screw placement is believed to require a smaller incision and less tissue dissection resulting in lower blood loss and faster healing; however, this has not yet been confirmed in clinical studies. OBJECTIVE: To compare CS transforaminal lumbar interbody fusions (TLIF), traditional pedicle screw (TPS) trajectory TLIFs, and posterolateral fusion (PLF) without interbody for differences in operative characteristics and complications...
January 13, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29303471/comparison-of-percutaneous-endoscopic-transforaminal-discectomy-microendoscopic-discectomy-and-microdiscectomy-for-symptomatic-lumbar-disc-herniation-minimum-2-year-follow-up-results
#14
Xinyu Liu, Suomao Yuan, Yonghao Tian, Lianlei Wang, Liangtai Gong, Yanping Zheng, Jianmin Li
OBJECTIVE This study aimed to evaluate the clinical outcomes of percutaneous endoscopic transforaminal discectomy (PETD), microendoscopic discectomy (MED), and microdiscectomy (MD) for treatment of symptomatic lumbar disc herniation (LDH). METHODS One hundred ninety-two patients with symptomatic LDH at L3-4 and L4-5 were included in this study. The mean (± SD) age of patients was 34.2 ± 2.6 years (range 18-62 years). The patients were divided into groups as follows: group A was treated with PETD and included 60 patients (31 men and 29 women) with a mean age of 36...
March 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29300964/piezosurgery-a-safe-technique-to-perform-lateral-suboccipital-craniotomy
#15
Juergen Grauvogel, Waseem Masalha, Dieter Henrik Heiland, Nadja Jarc, Tanja Daniela Grauvogel, Christian Scheiwe
BACKGROUND: Piezosurgery (PS) is a relatively new technique based on microvibrations generated by the piezoelectric effect. It selectively cuts bone tissue and preserves the surrounding soft tissue. OBJECTIVE: To evaluate the use of PS for performing lateral suboccipital craniotomy. METHODS: PS was used to perform a lateral suboccipital craniotomy in 22 patients who underwent surgery for different cerebellopontine angle (CPA) pathologies in the neurosurgical department...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29227037/prospective-transfrontal-sheep-model-of-skull-base-reconstruction-using-vascularized-mucosa
#16
Sarina K Mueller, George Scangas, Mansor M Amiji, Benjamin S Bleier
BACKGROUND: No high-fidelity animal model exists to examine prospective wound healing following vascularized reconstruction of the skull base. Such a model would require the ability to study the prospective behavior of vascularized mucosal repairs of large dural and arachnoid defects within the intranasal environment. The objective of this study was to therefore develop and validate a novel, in vivo, transfrontal sheep model of cranial base repair using vascularized sinonasal mucosa. METHODS: Twelve transfrontal craniotomy and 1...
December 11, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29223327/restoration-of-motor-function-after-operative-reconstruction-of-the-acutely-transected-spinal-cord-in-the-canine-model
#17
Zehan Liu, Shuai Ren, Kuang Fu, Qiong Wu, Jun Wu, Liting Hou, Hong Pan, Linlin Sun, Jian Zhang, Bingjian Wang, Qing Miao, Guiyin Sun, Vincenzo Bonicalzi, Sergio Canavero, Xiaoping Ren
BACKGROUND: Cephalosomatic anastomosis or what has been called a "head transplantation" requires full reconnection of the respective transected ends of the spinal cords. The GEMINI spinal cord fusion protocol has been developed for this reason. Here, we report the first randomized, controlled study of the GEMINI protocol in large animals. METHODS: We conducted a randomized, controlled study of a complete transection of the spinal cord at the level of T10 in dogs at Harbin Medical University, Harbin, China...
December 6, 2017: Surgery
https://www.readbyqxmd.com/read/29200173/medical-malpractice-claims-following-incidental-durotomy-due-to-spinal-surgery
#18
Wesley M Durand, Adam E M Eltorai, Govind Shantharam, J Mason DePasse, Eren O Kuris, Alicia E Hersey, Mark A Palumbo, Alan H Daniels
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Analyze medical malpractice verdicts and settlements associated with incidental durotomy. SUMMARY OF BACKGROUND DATA: Incidental durotomy is a common complication of spine surgery. While most intraoperative dural tears are repaired without sequelae, persistent CSF leak, infection, or neurological injury can yield adverse outcomes. The medicolegal implications of incidental durotomy are poorly understood...
December 4, 2017: Spine
https://www.readbyqxmd.com/read/29190646/risk-factors-for-incidental-durotomy-during-posterior-open-spine-surgery-for-degenerative-diseases-in-adults-a-multicenter-observational-study
#19
MULTICENTER STUDY
Hisatoshi Ishikura, Satoshi Ogihara, Hiroyuki Oka, Toru Maruyama, Hirohiko Inanami, Kota Miyoshi, Ko Matsudaira, Hirotaka Chikuda, Seiichi Azuma, Naohiro Kawamura, Kiyofumi Yamakawa, Nobuhiro Hara, Yasushi Oshima, Jiro Morii, Kazuo Saita, Sakae Tanaka, Takashi Yamazaki
Incidental durotomy (ID) is a common intraoperative complication of spine surgery. It can lead to persistent cerebrospinal fluid leakage, which may cause serious complications, including severe headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. As a result, it contributes to higher healthcare costs and poor patient outcomes. The purpose of this study was to clarify the independent risk factors that can cause ID during posterior open spine surgery for degenerative diseases in adults...
2017: PloS One
https://www.readbyqxmd.com/read/29186606/technique-of-minimally-invasive-cervical-foraminotomy
#20
Donald A Ross, Kelly J Bridges
BACKGROUND: Posterior cervical foraminotomy is a long utilized and commonly performed procedure, but has been supplanted in many cases by anterior procedures. With the advent of minimally invasive techniques, posterior foraminotomy may again deserve a prominent place in the treatment of cervical foraminal stenosis. OBJECTIVE: To report in detail a successfully utilized minimally invasive technique and the results in a large series of patients, by a single author...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
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